Provider Demographics
NPI:1255352696
Name:THOMAS E YOUNG MD LLC
Entity type:Organization
Organization Name:THOMAS E YOUNG MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-706-0883
Mailing Address - Street 1:1650 VALLEY CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-2344
Mailing Address - Country:US
Mailing Address - Phone:484-884-4436
Mailing Address - Fax:484-884-4444
Practice Address - Street 1:4825 W TILGHMAN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9322
Practice Address - Country:US
Practice Address - Phone:610-706-0883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020773E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1540038OtherIBC
PADC9572OtherRAILROAD MEDICARE
PADC9572OtherRAILROAD MEDICARE